Nematodes Lab

Nematodes
General features:
1. Elongated worm, cylindrical, unsegmented and
tapering at both ends.
2. Variable in size, measure <1 cm to about
100cm.
3. Sex separate and male is smaller than female
Location of Nematodes:
Intestinal nematodes
Tissue nematodes
Intestinal
Nematodes
Common intestinal nematode infections:
1. Enterobius vermicularis
(Pinworm,seatworm,threadworm)
2. Trichuris trichiura (whipworm)
3. Ascaris lumbricoides (roundworm)
4. Ancylostoma duodenale & Necator americanus
(hookworms)
5. Strongyloides stercoralis
6. :
Enterobius vermicularis
(Pin worm, seat worm,

thread worm(
 Found all over the world.
 adult in lumen of cecum and
appendix from which adult
female migrate to rectum.
 It can be seen by naked eye as
white thread ± 1cm.
 Male is smaller than female ±
0.5cm, with coiled end.
LIFE CYCLE
Pathology
 Majority of infection are
asymptomatic.
 Main clinical presentation pruritus
anal
perianal excoriation
 Ectopic enterobiasis occurs in female
when invade valva and vagina result in
valvovagintis
Treatment
ِAlbandazole , Mebendazole
for whole family
Ascaris lumbricoides
(roundworm)
(roundworm)
Ascaris adult
(roundworm)
The commonest human helminthes infection.
 Found in jejunum and upper part of ileum.
 Female ± 20 cm longer than male ± 10 cm
 .
(roundworm)
LIFE CYCLE
(roundworm)
Ascaris egg
)embryonated(
Ascaris eggs
Ascaris larva
Ascaris egg
embryonated(
(roundworm)
Pathology:
 1-Adult worm:
Light infection : asymptomatic.
Heavy infection : intestinal obstruction
Migrating adult : to bile duct -jaundice
 2-Larvae: Loeffler`s syndrome
Pneumonia, cough with bloody sputum
Eosinophilia, urticaria
(roundworm)
Ascaris larva in lung

(roundworm)
Diagnosis:
-eggs in stool.
-larvae in sputum.
-adult may pass with stool.
Treatment: Albendazole , Mebendazole

Trichuris trichiura (Whipworm)
LIFE CYCLE
World wide ,common in poor sanitation.
 It coexists with Ascaris because of
similar requirement.
 Adult live in large intestine especially
caecum and appendix –in heavy
infection the whole length of large
intestine affected.
 Male and female worm have narrow
anterior portion penetrate the
intestinal mucosa
Pathology
 light infection : asymptomatic
 heavy infection :abdominal pain ,bloody
diarrhea.
Diagnosis: egg in stool characterized by its
barrel shape with mucoid plugs at each pole .
 Treatment :Albendazole.
Embryonated egg Unembryonated egg

Infective stage Diagnostic stage
 -Diagnosis: egg in stool characterized by its

barrel shape with mucoid plugs at each pole .
 Treatment :Albendazole.
Hook worms
Ancylostoma dudenale &Necator americanus
Hook worms
LIFE CYCLE
Hook worms
 A common cause of anemia.

 Found in small intestine mainly
jejunum.
 Its buccal capsule (mouth) lined with hard
hooks, triangular cutting plates and
anticoagulant glands.
Hook worms
pathology& clinical picture:

- larvae:
i-At the site of entry of larvae
(ground itch).
ii- Migration phase:
cough with bloody sputum
pneumonia, eosinophilia,urticaria.
- Adult worm:
•low worm burden: no symptoms.
•Moderate to heavy burden:
epigastric pain, vomiting ,simulating
duodenal ulcer, hemorrhagic enteritis.
Hook worms
• Anemia: due to with drawl of blood by

parasites and hemorrhage from
punctured sites lead to sever
anemia.
Hook worms
 Diagnosis:
 -Eggs in stools.;
Treatment: Albendazol, Mebendazole

Strongyloides stercoralis
 Widely distributed in tropical region

worldwide .
 fetal opportunistic in immuno-
compromised host.
 It is smallest pathogenic nematodes
± 2.5mm.
 adult live in mucous membrane of
duodenum jejunum
LIFE CYCLE
 Pathology and clinical picture:
 1-Cutaneous little reaction on penetration.
sever dermatitis at perianal region in
case of external autoinfection.
 2- Migration :same as hook worms .
 3- Intestinal: inflammation of upper intestinal mucosa,
diarrhea, upper abdominal pain clicky in nature.
 Disseminated strongyloidiasis : in patient with
immunodeficiency ,uncontrolled diarrhea –
granulomaturs changes –necrosis--perforation--
peritonitis--death.
Diagnosis:
rhabditiform larvae
diagnostic stage in:
-Stool examination
-Duodenal aspirate
Treatment :
Albandazole,
Mebendazole
TISSUE NEMATODES
TISSUE NEMATODES
COMMON TISSUE NEMATODE INFECTIONS
 Trichinella spiralis adults in small intestine larvae in tissues
(mainly in muscles).
 Toxocara canis (dog roundworm) larvae in organs (liver brain

eyes), causing visceral larva migrans
 Filarial worms
Trichinella
spiralis
Trichinosis
Pathology:
Adults cause mild gastroenteritis.
Larvae cause fever, myositis and multi-system
involvement which may lead to death.
Diagnosis: serology, muscle biopsy.
Treatment: Albendazole or Mebendazole +

corticosteroids
Trichinosis
Visceral larva migrans:
Caused by Toxocara canis
 Mainly affects children who eat soil
contaminated with emberyonated
(infective) eggs of Toxocara canis.
 Larvae do not develop in humans but
migrate continuously in viscera and
encapsulate, causing tissue damage.
Toxocara canis
 Pathology: Eosinophilia, hepatomegaly,
retinitis.
 Diagnosis: serology, biopsy.
 Treatment: Albendazole
FILARIAL WORMS: (Adult worms +
microfilariae)
1. Onchocerca volvulus:
Adults in subcutaneous swellings Microfilariae : mainly in skin, eyes causing River blindness
2. Wuchereria bancrofti, Brugia malayi & B. timori:
Lymphatic filariasis (adults in lymphatics,
microfilariae in blood)
3. Loa loa:
Adults in subcutaneous and subconjunctival tissues, causing Calabar swellings.
Microfilariae in blood
Onchocerciasis (river blindness)
Pathology:
Adults worms live in subcutaneous nodules.
Main pathology caused by microfilariae in:
 Skin: dermatitis
 Lymph nodes: lymphadenopathy
 Eyes: blindness
Diagnosis: skin snip to identify microfilariae.
Treatment: Ivermectin
LYMPHATIC FILARIASIS
Mainly caused by Wuchereria bancrofti

and Brugia malayi
Pathology:
Due to adult worm obstructing lymphatics.
 Acute: lymphadenitis lymphatic varices
 Chronic: lymphedema, hydrocele, chyluria.

Diagnosis: detection of
microfilariae in blood in
early stages of the disease:
Blood film, Knott’s method
( concentration of 1 ml of
blood), best 10 pm to 2 am
Immunological tests:
Treatment:
diethylcarbamazine
(DEC) or ivermectin
Loa loa
Loiasis
 Pathology: Adult worm

continously migration in
subcutaneous and
subconjuntival tissues,
causing Calabar swellings
(allergic reactions) and
conjunctivitis.
Loiasis
 Diagnosis: detection
of microfilariae in blood
film.
 Treatment:
diethylcarbamazine
(DEC) or ivermectin,
surgical remonval.
NON-FILARIAL TISSUE NEMATODE
INFECTIONS
Nematode Disease Mode of Location in Diagnosis treatment
species transmission human
Trichinella Trichinellosi ingestion Muscles, lungs Serology, albendazole

spiralis s larvae in brain muscle
(trichinosis) under- biopsy
cooked pork
Toxocara Visceral Ingestion of Abdominal Serology, albendazole

canis larva infective organs and ELISA
migrans eggs in soil brain
MAJOR FILARIAL INFECTIONS OF HUMANS
species Disease Geographic Location of Location of vector Lab.
distribution adult in microfilaria diagnosis
humans
Wuchereri elephantiasis Tropical Lymphatic Blood mosquitoes Blood

a bancrofti and vessels (nocturnal film
subtropical periodicity)
areas
Brugia elephantiasis Asia Lymphatic Blood mosquitoes Blood
malayi vessels (nocturnal film
periodicity)
Onchocerc Onchocerciasis Africa, Subcutaneous Skin, eyes, Simulium Skin snip

a volvulus (river Central and nodules no spp. (black
blindness) South periodicity fly)
America,
Yemen
Loa loa loiasis Central Moving in Blood Chrysops Blood

Africa subcutaneous (diurnal spp. (deer film
tissues periodicity) fly)

Nematodes Lab

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Nematodes

2. Trichuris trichiura (whipworm)

3. Ascaris lumbricoides (roundworm)

4. Ancylostoma duodenale & Necator americanus

(Pin worm, seat worm,

 Female ± 20 cm longer than male ± 10 cm

Ascaris larva in lung

Treatment: Albendazole , Mebendazole

Embryonated egg Unembryonated egg

 -Diagnosis: egg in stool characterized by its

 A common cause of anemia.

pathology& clinical picture:

• Anemia: due to with drawl of blood by

Treatment: Albendazol, Mebendazole

 Widely distributed in tropical region

 Toxocara canis (dog roundworm) larvae in organs (liver brain

Diagnosis: serology, muscle biopsy.

Treatment: Albendazole or Mebendazole +

 Diagnosis: serology, biopsy.

 Lymph nodes: lymphadenopathy

Diagnosis: skin snip to identify microfilariae.

Mainly caused by Wuchereria bancrofti

Due to adult worm obstructing lymphatics.

 Acute: lymphadenitis lymphatic varices

 Chronic: lymphedema, hydrocele, chyluria.

 Pathology: Adult worm

Trichinella Trichinellosi ingestion Muscles, lungs Serology, albendazole

Toxocara Visceral Ingestion of Abdominal Serology, albendazole

Wuchereri elephantiasis Tropical Lymphatic Blood mosquitoes Blood

Onchocerc Onchocerciasis Africa, Subcutaneous Skin, eyes, Simulium Skin snip

Loa loa loiasis Central Moving in Blood Chrysops Blood

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